Sure. Unfortunately, the prenatal ultrasound detection rate for fetal cardiac defects is variable between 15-70% among centers, with the largest ones having the best results. As you can tell, short of having a fetal echo, the routine prenatal ultrasound (or even a comprehensive/targeted one) can miss even major cardiac defects in 30-85% of cases. Take Folic Acid to prevent heart defects in you fetus!
Fetal. Yes if it is a Minor one or if it is a genetic arrhythmia syndrome.
What are the risks of operating on a child with a congenital heart defect? My child was diagnosed with a congenital valve problem very soon after birth. What are the risks associated with operating on a very young child?
If. If the surgery is performed in a high volume center with good pediatric cardiac surgeons the risks are low. The risks may include some degree of left over valve obstruction or leakage. Very small risk of bleeding, infection. The risks also depend on how sick the child is prior to surgery and which valve is affected. There is also some chance that the involved valve may not be able to be repaired adequately and may have to be replaced with a prosthetic valve. That decision will sometimes have to be taken by the cardiac surgeon on the table in the or.
Benefits vs. Risks. The pediatric cardiovascular surgeon will tell you the risks & rates of complications vs. The risks of the heart's having to work extra hard to supply blood & oxygen to the brain & body if the chd is left untreated. Neonatal open heart surgery is done to insure optimal health, growth & development. Tour the cicu, meet the nurses, ask @ pumping & storing breast milk & call on family support.
Yes. Most important congenital heard defects can be detected by fetal ultrasound. The person (doctor or sonographer) needs to have a certain amount of training and expertise to make sure all of the appropriate images are obtained. Plus the physician (perinatologist or pediatric cardiologist) who is interpreting the images needs to have a full understanding of congenital heart disease.
Absolutely. This is exactly why these screens are done. The vast majority of abnormalities can be picked up on the screening US. If they see something suspicious, though, they should offer or you should insist on a higher level screening - in the case of the heart, a fetal ECHO should be done by a pediatric cardiologist who is trained specifically in fetal ECHO. Info obtained before birth is extremely helpful.
Bicuspid aortic valv. The most common congenital heart defect is bicuspid aortic valve. The other most common defects are atrial septal defects, ventricular septal defects, and patent ductus arteriosus.
Hard question. This depends on who is evaluating. It is highly unusual for an important congenital heart defect to be missed by a pediatric cardiologist. A major diagnostic tool for the diagnosis of congenital heart disease is a careful, focused physical examination. Echocardiography under the direction of a pediatric cardiologist is an important, reliable tool to confirm the diagnosis and establish details.
Yes. ASD in particular is very hard to detect on exam.
Yes. Most severe defects will be found quickly. Some of my patients were diagnosed between 6 months and 3 years old. A few defects such as ASD (atrial septal defect) may not be diagnosed until adulthood.
Define defect. The complexity of how the heart forms gives rise to many possible errors, defects. The worst are diagnosed within hours of birth. Some significant ones (VSD, ASD, AS) are usually picked up on exam in the first weeks. Some are normal structures that may malfunction. (PDA) Rare re-routing of heart blood supply can be undetected. A PFO is a normal incidental finding on an autopsy in most people.
Many. Heart defects can range from holes between chambers to missing chambers to incorrect formation of blood vessels.
No. Although occasionally someone with a congenital heart defect is confined to a wheelchair, it rarely has anything to do with their heart defect.
Blueish color murmur. Decreased oxygen saturation tends to render a purplish/blueish hue to the lips and/or digits in cases of complex congenital cardiac defects. Additionally, heart murmurs and symptoms of weakness, shortness of breath, dizziness with exercise can all be seen with such defects. Consult with a pediatric cardiologist and cardiovascular surgeon for repair/management.
VSDs. Ventricular septal defects are by far the most common congenital cardiac defects.
ASD and VSD. Atrial and ventricular septal defects are generally considered the most common forms of congenital heart disease. There are some differences based on geographic location, sex, and race as well, but ASDs and VSDs are generally most common among all human beings.